What Goes into Maintaining Sanity When You Have a Mental Illness

There is a great deal of work that goes into maintaining a sense of “sanity” while living with a mental illness.  I don’t remember the last time I felt truly happy.  And I’m beginning to wonder if I’ll ever have the ability to experience it.  I base that on my own definition of these emotions.  Happiness to me is a state of pleasure that exists without negative cognitive backlash. That’s what my illness has done to me, it’s taken my ability to experience emotions the same way as a neurotypical (i.e. mentally healthy) person does.   I’ve been called a pessimist, and a fatalist.  I’ve been  told that I’m allowing my bipolar depression taint and distort my view of the world, and that I’m not complying to my cognitive therapy.  People say, “You’re simply accepting your situation and not doing anything about it!” HA!!  This is how it actually is: 

Through extremely hard work, and a lot of inner reflection and self-actualization, I’ve been able to identify that the constant presence of symptoms has impaired my ability to feel happiness to the extent that I used to before my illness developed.  Singer/ songwriter Matthew Good has been quoted comparing his bipolar disorder to a hibernating bear.  Well, if I am to use the same analogy, my bear is always awake and always growling.  There are periods of time where the growling is more of a soft grumble, but I can’t escape, it holds me in its ginormous paws for 24 hours a day, 7 days a week.  The continuous presence of my disorder doesn’t mean that I’m not high-functioning or that I’m living a miserable existence.  It doesn’t mean that I have frequent visits to the hospital or that I can’t hold a job.  But it does mean that I have to work fucking hard to be able to do the things that I do, like go to my internship for example.  Although they might have woken up tired and in a shitty mood, a neurotypical person can get up, grab coffee and get through the day without being constantly reminded of how shitty their day started out.  When I wake up, I have to fight through the full body hurt that is a side-effect of my sleeping meds, get through the grogginess without the aid of caffeine, remember to take my daily meds, and get on with my super structured day (part of managing the bipolar and comorbid illnesses) all the while being inundated by negative thoughts and rumination.  I can’t count how many times I have to confront my brain telling me, “You’re too tired for this, go back to bed”, “Why do you even try? You just end up feeling miserable in the end”, “You’re fat and ugly”, “You’re not worth it”, “You’ve been at this so long, you’re tired, it could all be over in a second”, “You’re so fucking stupid, why can’t you do anything right”, “Hey remember that time you said, _____, and so and so gave you that look? Why the fuck did you do that, you stupid, fucking piece of shit”.  These thoughts aren’t just occasional or the result of something bad actually happening, they are recurring a minimum of 7 times an hour, and happen regardless of awesome things may be going in my life.  I’m not asking for a pity party, and I certainly don’t go through my entire life pitying myself.  I’m just trying to describe my experience, as accurately as I can, so as to demonstrate that having a mental illness—even in periods of “wellness” is really hard.  So, if you have the mindset that active illness happens only periodically? Guess again.  Have you been told that every person with a mental illness can recover completely? Some people can, but some people don’t.  Ugh, I hate the word “recovery”.  To the general public it implies that mental illness can be cured.  It can’t, but I’m optimistic that medical researchers will find a way to do so in my lifetime.  People with mental illness and those who work with them know that the term “recovery” is used to describe the journey from active symptoms, to a period where the illness is in “remission”, so, an absence of or decrease in symptoms.

So what do I do to manage my illness? A lot of things!  The most important thing is medication.  If we could treat mental illness through herbal supplements, sleep, diet and exercise only, medication wouldn’t exist (and we have been treating mental illness with “natural” therapies for centuries, and it’s only now, with the added benefit of medication, that we are seeing results).  Please, do not listen to the conspiracy theorists!  The prescribing of medication is not some scam being pulled off by big pharmaceutical companies and psychiatrists, not to say that there isn’t abuse going on.  Doctors prescribe medication, ECT, and other new medical therapies to psychiatric patients because mental illness is caused by a combination of structural and neurochemical abnormalities in the brain that are genetic.  Saint John’s wart isn’t going to turn your small hypothalamus into a “normal” sized one.  No amount of veggies or step classes is going to make particular genes disappear or turn off.  The only method that has been tried, tested, and true, is taking medication.  I know that taking medication is a pain in the ass, expensive, and causes side effects—sometimes really nasty ones—but in my own personal experience in combination with therapy, I have seen a tremendous amount of progress since taking daily medication.  The second most important thing for managing my illness is getting enough SLEEP.  I still don’t fully understand why this is a huge trigger, but if I don’t sleep all hell breaks loose.  For a while, my insomnia was so bad that I was so sick and couldn’t function—hence the sleeping meds.  Unfortunately I’ve become dependent on sleeping meds, but I’ve managed to lower the dosage as my sleep hygiene improves. 

As mentioned above, I have a highly structured routine that I try my best to stick with.  I find that organization and scheduled activities help with my anxiety and also help to manage hypomania.  A chaotic environment makes me feel more out of control when I’m hypomanic, and more helpless when I’m depressed.  I’m not very good with my exercise routine unfortunately—I need to work on it—but when I do well with it, it helps with the aches and pains that are both a side effect of medication and symptoms of a chronic physical illness I have.  I reap the same benefits and more from a gluten-free, low fodmap diet that is in the form of regular snacks/meals.  I’m no longer in therapy, but I use the tools I’ve learned from Cognitive Behavioural Therapy (CBT) daily, and using CBT workbooks on occasion when symptoms are particularly troublesome, is good practice.  I also journal a lot.  I have journal for just venting, a journal for writing positive reminders and keeping track of my little successes, and a journal for counteracting dysfunctions.  My dysfunction journal works like this: I identify something I’m struggling with that day, reflect on why I’m struggling with it and identify what I’m getting out of it even though it’s hurting me, write about the negative consequences of it, and then offer myself strategies for overcoming it.  It’s extremely important to not socially isolate myself and to regularly do little things that make me feel good, like hula hooping, painting my nails, soaking my feet, putting on body lotion, petting my cats etc.  Challenging the mind is key to a healthy mind, so I’m always reading and educating myself on new things.  All of this might sound pretty easy, but it is time consuming and takes a lot of mental energy, focus, and dedication and I really wish more would recognize the effort that individuals with mental illness put into daily life.